Monica Rosignoli - Academia.edu (original) (raw)

Papers by Monica Rosignoli

B-ENT

It is common in clinical practice to administer systemic steroids to treat sensorineural hearing ... more It is common in clinical practice to administer systemic steroids to treat sensorineural hearing loss due to bullous myringitis (BM). Nonetheless, there is currently no definitive evidence that steroid therapy is effective and appropriate for BM. The aim of this study was to assess the effectiveness of systemic steroid therapy for treating BM. This prospective study included 23 patients affected by BM with sensorineural hearing loss (median age, 45.8 years). The subjects were divided into two groups: Group A received only systemic antibiotic treatment and Group B received systemic antibiotics plus systemic steroid treatment. There were no differences between the groups in terms of the sensorineural hearing loss recovery. Both treatments were effective, suggesting that administration of oral steroids in combination with antibiotics did not confer an advantage in terms of sensorineural hearing loss recovery rate in the tested population.

BioMed Research International, 2015

Background. Specific clinical conditions could compromise cochlear implantation outcomes and dras... more Background. Specific clinical conditions could compromise cochlear implantation outcomes and drastically reduce the chance of an acceptable development of perceptual and linguistic capabilities. These conditions should certainly include the presence of inner ear malformations or brain abnormalities. The aims of this work were to study the diagnostic value of high resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in children with sensorineural hearing loss who were candidates for cochlear implants and to analyse the anatomic abnormalities of the ear and brain in patients who underwent cochlear implantation. We also analysed the effects of ear malformations and brain anomalies on the CI outcomes, speculating on their potential role in the management of language developmental disorders. Methods. The present study is a retrospective observational review of cochlear implant outcomes among hearing-impaired children who presented ear and/or brain anomalies at neuroimaging investigations with MRI and HRCT. Furthermore, genetic results from molecular genetic investigations (GJB2/GJB6 and, additionally, in selected cases, SLC26A4 or mitochondrial-DNA mutations) on this study group were herein described. Longitudinal and cross-sectional analysis was conducted using statistical tests. Results. Between January 1, 1996 and April 1, 2012, at the ENT-Audiology Department of the University Hospital of Ferrara, 620 cochlear implantations were performed. There were 426 implanted children at the time of the present study (who were <18 years). Among these, 143 patients (64 females and 79 males) presented ear and/or brain anomalies/lesions/malformations at neuroimaging investigations with MRI and HRCT. The age of the main study group (143 implanted children) ranged from 9 months and 16 years (average = 4.4; median = 3.0). Conclusions. Good outcomes with cochlear implants are possible in patients who present with inner ear or brain abnormalities, even if central nervous system anomalies represent a negative prognostic factor that is made worse by the concomitant presence of cochlear malformations. Common cavity and stenosis of the internal auditory canal (less than 2 mm) are negative prognostic factors even if brain lesions are absent.

Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2014

ABSTRACT But de la présentation Évaluer l’utilisation des ASSR dans la prédiction du seuil auditi... more ABSTRACT But de la présentation Évaluer l’utilisation des ASSR dans la prédiction du seuil auditif dans les patients en âge pédiatrique affectés par hypoacousie neurosensorielle congénitale, moyennant la comparaison avec potentiels évoqué auditifs (PEA) et méthodiques subjectives (test auditif comportemental, audiométrie tonale liminaire). Matériel et méthodes L’échantillon examiné comprend 23 enfants, 11 garçons et 12 filles (pour un total de 31 oreilles) affectés par hypoacousie neurosensorielle congénitale. Chaque patient a été soumis à une anamnèse, otoémissions acoustiques provoquées, tympanométrie, PEA, ASSR. Le test auditif comportemental et l’audiométrie tonale liminaire ont été faits à des intervalles variables dans le temps en relation au développement psycho-physique de l’enfant. Résultats Hypoacousie neurosensorielle unilatérale a été diagnostiquée en 3 enfants, bilatérale en 20 enfants. En 12 cas (52,1 %) ont été rencontrés des facteurs de risques pour hypoacousie congénitale. Les patients ont été soumis à une estime du seuil moyennant l’étude ASSR à un âge moyen de 58,9 mois (3–189 mois) ;audiométrie tonale a été faite entre les 25 et les 189 mois (âge moyen 73,5 mois). Le laps de temps moyen entre l’exécution du ASSR et l’examen audiométrique a été de 14,6 mois. L’âge moyen des enfants soumis à l’examen ABR a été de 43,4 mois. La valeur moyenne du seuil ASSR pour les fréquences de 0,25, 0,5, 1, 2 et 4 kHz a été respectivement de 65,00 ± 11,83 dB, 51,91 ± 19,27 dB, 73,53 ± 17,57 dB, 76,33 ± 19,50 dB, 67,04 ± 17,28 dB. La valeur moyenne du seuil à l’audiométrie tonale liminaire pour les fréquences de 0,25–4 kHz a été respectivement de 45,47 ± 19,02 dB, 46,78 ± 20,78 dB, 58,49 ± 24,02 dB, 65,93 ± 25,48 dB, 67,39 ± 27,42 dB. Donc la relation du seuil (ASSR vs audiométrie tonale liminaire, 0,25–4 kHz) a résulté hautement significatif : le coefficient de relation de Pearson (Rsq) a été de 0,18, 0,75, 0,66, 0,78, 0,63 respectivement pour les fréquences 0,25, 0,5, 1, 2 et 4 kHz. Conclusion L’estime du seuil obtenu à l’aide des Auditory Steady State Responses se relie hautement avec le seuil auditif dans les patients en âge pédiatrique. La mesure ASSR peut donc représenter un outil clinique dans l’évaluation audiologique pédiatrique et peut se révéler très intéressante dans une optique de réglage d’aides auditives.

Audiology : official organ of the International Society of Audiology

An epidemiological study comparing speech audiometry with self-assessed hearing disability and an... more An epidemiological study comparing speech audiometry with self-assessed hearing disability and an analysis of other factors influencing the quality of life was conducted. In the Veneto region (Italy), a representative sample of 2700 independently living individuals of 65 years of age and older was selected for the study. All participants were administered a comprehensive questionnaire and a brief examination at their home, including a general physical examination, speech audiometry, Sanders' Speech Disability test, part I and III, Mini Mental State Examination, CES-D scale for depression, visual acuity, self-reported diseases and physical function. Auditory function was worst in the older individuals: auditory performance was within acceptable limits up to the 75-79 age group, while it rapidly deteriorates in the older groups. This trend is consistent with self-reported auditory disability (Sanders' test). A detailed analysis of the type of errors made in the speech audiomet...

International Journal of Pediatric Otorhinolaryngology, 2013

Objectives: Cochlear implantation is a relatively safe procedure with a low complication rate. Th... more Objectives: Cochlear implantation is a relatively safe procedure with a low complication rate. The overall rate of complications among cochlear implant patients ranges from 6% to 20%. Major complications are those that are life-threatening or require surgery, whereas minor complications are those that can be medically treated. Nonetheless, certain complications, even if highly rare, may require specific investigations and treatments. Among these rare complications are those with endocochlear involvement, such as cochleitis or labyrinthitis, with fibrosis or ossification that could lead to explantation. The aims of the present study were to report a particular case of post-operative cochleitis and to review the rate of complications after cochlear implantation, emphasising those conditions with proven endocochlear involvement. Methods: We refer to the case of an eight-year-old Italian boy affected by the sudden onset of headache, ipsilateral otalgia and facial paresis, who presented to our clinic for inexplicable worsening of the performance of his implant and his residual hearing, six years after surgery. A complete investigation including (clinical history, routine, autoimmune and serological blood tests, electrophysiological measurements from the cochlear implant and neuroimaging) was performed and is herein described. Additionally, a comprehensive review of the literature was conducted using internet search engines; 274 papers were selected, 88 of which were best suited to our purposes. Results: In our case, the progression of the symptoms and the performance decrement required explantation, followed by a complete recovery. Reviewing the literature revealed only three reports concerning cases of proven endocochlear phlogosis that required revision surgery. Wound swelling/ infection and vertigo remain the two most common complications of cochlear implantation. Failure of the device is the third most frequent complication (10.06% of all complications and 1.53% of cochlear implantations). Other rare conditions (such as granulating labyrinthitis with cochlear fibrosis, ossification and erosion, silicone allergy and the formation of a biofilm around the internal device) are possible and unpredictable. Although rare (approximately 1%), such cases may require explantation. Conclusions: Despite efforts by both surgeons and manufacturers, device-related and surgical complications still occur. These and other rare conditions demand specific management, and their frequency may be underestimated. Further studies are needed to assess more realistic rates of complications and devise more efficient strategies for early diagnosis and treatment.

International Journal of Pediatric Otorhinolaryngology, 2007

Objective: This study aims to investigate the clinical features and outcomes of acute mastoiditis... more Objective: This study aims to investigate the clinical features and outcomes of acute mastoiditis in children referred to the ENT/Audiology Department of the University of Ferrara from January 1994 to December 2005. It also aims to discuss risk factors and to find predictors for surgery. Methods: A retrospective study on case sheets of children with an acute mastoiditis diagnosis was carried out. Fifty-five cases fulfilled the inclusion criteria: they presented otoscopical evidence of acute otitis media and inflammatory findings of the mastoid area such as post-auricular swelling, redness or tenderness, protrusion of the auricle and/or radiological findings. Results: Twenty-six patients were only treated with antibiotic therapy, tympanocentesis alone was performed in 11 cases; in 5, a ventilation tube was positioned. Mastoidectomy was performed in 13 patients.

International Journal of Pediatric Otorhinolaryngology, 2011

Acta Oto-laryngologica, 2014

Remote programming is safe and is well received by health-care professionals and cochlear implant... more Remote programming is safe and is well received by health-care professionals and cochlear implant (CI) users. It can be adopted into clinic routine as an alternative to face-to-face programming. Telemedicine allows a patient to be treated anywhere in the world. Although it is a growing field, little research has been published on its application to CI programming. We examined hearing professionals&amp;amp;amp;#39; and CI users&amp;amp;amp;#39; subjective reactions to the remote programming experience, including the quality of the programming and the use of the relevant technology. Remote CI programming was performed in Italy, Sweden, and Russia. Programming sessions had three participants: a CI user, a local host, and a remote expert. After the session, each CI user, local host, and remote expert each completed a questionnaire on their experience. In all, 33 remote programming sessions were carried out, resulting in 99 completed questionnaires. The overwhelming majority of study participants responded positively to all aspects of remote programming. CI users were satisfied with the results in 96.9% of the programming sessions; 100% of participants would use remote programming again. Although technical problems were encountered, they did not cause the sessions to be considerably longer than face-to-face sessions.

International Journal of Audiology, 1997

Sixty-five families with non-syndromal sensorineural hearing loss (NS-SNHL) of genetic aetiology ... more Sixty-five families with non-syndromal sensorineural hearing loss (NS-SNHL) of genetic aetiology were subtyped according to Gorlin et al. Individual audiogram shapes were also classified in order to detect inter- and intra-familial variations. In 48 families with an Autosomal Dominant (AD) inherited form, 26 exhibited the features of (high-frequency) progressive NS-SNHL, 12 those of mid-frequency NS-SNHL, 5 were affected by congenital low-frequency NS-SNHL; 1 kindred showed a progressive low-frequency pattern and another 1 a unilateral NS-SNHL; only 3 kindreds were affected by severe congenital NS-SNHL. Autosomal Recessive (AR) inherited forms were composed of 9 kindreds with severe congenital NS-SNHL, and 7 with moderate congenital NS-SNHL. One X-linked form was identified. AD- and AR-inherited NS-SNHL differed significantly both in severity of hearing impairment and in audiogram shapes. With few exceptions, in each family classified according to Gorlin, most of the affected subjects shared the same audiogram profile. Intrinsic progression of the disease versus ageing was studied in the larger subtype of individuals with the high-frequency loss. Gorlin&amp;#39;s classification still remains the best system to classify NS-SNHL, and can provide a broad base to separate a very heterogeneous group of disorders. Results obtained in gene mapping in single large human families or in homologous gene search could be tested in our families. For some of them, namely those with high frequency progressive and low-frequency NS-SNHL, testing should already be feasible.

European Archives of Oto-Rhino-Laryngology, 2014

The objective of our study was to review retrospectively the clinical, radiological and therapeut... more The objective of our study was to review retrospectively the clinical, radiological and therapeutic findings in 62 adults with acute mastoiditis treated at the ENT Department of Ferrara from 1992 to 2010. 62 adult cases fulfilled the following inclusion criteria: otoscopical evidence of co-existent or recent otitis media; postauricular swelling, erythema or tenderness; protrusion of the auricle; fever and/or significant radiological findings of mastoiditis. Conservative treatment comprehended antibiotic ± ventilation tube. Surgical procedures comprehended mastoidectomy or mastoido-tympanoplasty. The incidence of adult's mastoiditis in our district (0.99 cases/year/100.000 inhabitants) has maintained quite stable during the considered 19-year period. The typical clinical presentation was observed in 48 % of cases. Complications were meningitis (15 cases), meningo-encephalitis (1), meningitis associated with lateral sinus thrombosis (1), facial nerve paralysis (11), and labyrinthitis . In all cases except one, the facial palsy recovered completely and no mortality was observed due to these complications. Complete cure was obtained with conservative treatment in 69 % of uncomplicated cases and in 24 % of patients with intracranial complications. Mastoiditis in adults may present as the acute classical form, as well as latent forms which often have prolonged and insidious development followed by a rapid clinical deterioration. Clinical features are frequently atypical, while incidence of meningitis and other complications is still high particularly in the most elderly. Thus, great care is required from clinicians to make an early diagnosis in order to promote adequate treatment.

European Archives of Oto-Rhino-Laryngology, 2012

Our objective is to determine the complication rate in a population of infants, children, adolesc... more Our objective is to determine the complication rate in a population of infants, children, adolescents and adults, from a University Hospital Cochlear Implant program and to discuss their causes and treatments. The methods include a retrospective study of 438 consecutive patients in a tertiary referral centre, the Audiology Department of the University Hospital of Ferrara. All patients receiving cochlear implants, between 1 January 2003 and 31 December 2009, have been included. All complications and treatments were systematically reviewed with an average duration of follow-up of 46 months (range 10-84 months). The results reveal that the overall rate of complications in our group was 9.1% (40 of 438), and most of them were minor. Wound swelling and infections represent the most common complication occurred. There were no cases of transient or permanent facial palsy following surgery, and also we did not register any case of postsurgical meningitis. Thirteen patients (3.0%) underwent explantation followed by reimplantation. In conclusion, we find that Cochlear implantation is a safe low-morbility technique with a relatively low complication rate in the presented population.

Cochlear Implants International, 2012

The aims of this study were to collect data on electrically evoked compound action potential (eCA... more The aims of this study were to collect data on electrically evoked compound action potential (eCAP) and electrically evoked stapedius reflex thresholds (eSRT) in HiResolution(TM) cochlear implant (CI) users, and to explore the relationships between these objective measures and behavioural measures of comfort levels (M-levels).

Audiology and Neuro-Otology, 1998

The study aimed at the development of a clinically applicable methodology that could: (1) discrim... more The study aimed at the development of a clinically applicable methodology that could: (1) discriminate transient evoked otoacoustic emission (TEOAE) recordings from normal hearing or hearing impaired individuals; (2) classify the nature of the hearing loss as conductive or as cochlear, and (3) define clear-cut TEOAE clinical criteria. A classification algorithm based on a multivariate discriminant analysis of fast Fourier transform data from recordings evoked by click stimuli of 50 +/- 2, 62 +/- 2, 68 +/- 2 and 80 +/- 2 dB SPL was used to discriminate 302 normal subjects from 383 subjects suffering from mild to moderate hearing losses. The best discriminant model (QDF80) produced a sensitivity of 93.8% and a specificity of 79.4%. When extra correlation criteria were serially applied to the classification outcome, the specificity was increased to 85.3%, but the sensitivity was marginally decreased to 91.7%. The classification of the correctly identified hearing-impaired cases yielded 93.8% identification of conductive and 75.1% identification of cochlear cases. A sensitivity analysis of the misclassified hearing-impaired cases suggested that the TEOAE spectra are well correlated with the 2-kHz but poorly correlated with the 4-kHz octave frequency.

Acta Oto-laryngologica, 2007

Conclusion: An epidemiological survey of hospitals and private clinics in Japan regarding idiopat... more Conclusion: An epidemiological survey of hospitals and private clinics in Japan regarding idiopathic sudden sensorineural hearing loss (SSNHL) revealed that the incidence of SSNHL was 60.9 per 100 000 population. There were more females than males in the younger generation. Objective: The incidence of SSNHL varies largely by country. Because the Japanese criteria for diagnosing SSNHL have changed in accordance with those widely used in other parts of the world, a clinicoepidemiological study was undertaken using the new criteria. Methods: Ehime, Aichi, and Iwate Prefectures were selected from the western, central, and northeastern regions of Japan, respectively. The subjects for this study were patients who suffered SSNHL between April 1, 2012 and March 31, 2013. Questionnaires were mailed to all hospitals and private clinics in which ENT doctors were working. Initial and final audiograms were requested for 10% of the patients. Results: In all, 78 of 90 hospitals (87%) and 303 of 407 private clinics (74%) responded. It was reported that 1663 patients visited hospitals and 3090 patients visited only private clinics. It was estimated that 6205 SSNHL patients visited hospitals or private clinics in 1 year from a population of 10 145 000. Also, 23% of patients suffered acute low-tone SNHL (female to male ratio; 3:1 in definite cases).

International Journal of Audiology, 2001

Original Artide Audiology 2001; 40:285 -293 Alessandro Martini* Manuela Mazzoli* Monica Rosignoli... more Original Artide Audiology 2001; 40:285 -293 Alessandro Martini* Manuela Mazzoli* Monica Rosignoli* Patrizia Trevisì* Stefania Maggi^ Giuliano ... en la senectud: un estudio poblacional Abstract An epidemiological study comparing speech audiometry with self-assessed hearing ...